@layout("/common/_form.html",{js:["/assets/btyDbdkYingfu/btyDbdkYingfu_edit.js"]}){

<form class="layui-form" id="btyDbdkYingfuForm" lay-filter="btyDbdkYingfuForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">收款店名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="skdm" name="skdm" placeholder="请输入收款店名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">辅助核算店名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="fzhsdm" name="fzhsdm" placeholder="请输入辅助核算店名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">金额<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="amount" name="amount" placeholder="请输入金额" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">用友大区编号<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="bh" name="bh" placeholder="请输入用友大区编号" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">0失败1成功<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="flag" name="flag" placeholder="请输入0失败1成功" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">失败原因<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="errormsg" name="errormsg" placeholder="请输入失败原因" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>

</form>

@}